PANCREATOGASTROSTOMY WITH ONE CONTINUOUS SEROMUSCULAR CIRCULAR SUTURE
| Autor: | Georgi L. Kobakov, Kostov D, Daniel Yankov |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
pancreas cancer surgery medicine.medical_treatment lcsh:Medicine Anastomosis Pancreaticoduodenectomy Pancreaticogastrostomy Suture-less pancreaticogastrostomy Suture (anatomy) medicine pancreatic surgery Pancreatic duct Gastric emptying business.industry Postoperative pancreatic fistula lcsh:R Postoperative complication medicine.disease Surgery medicine.anatomical_structure cancer of pancreas Pancreatic fistula business Pancreas |
| Zdroj: | International Journal of Surgery and Medicine, Vol 1, Iss 1, Pp 2-6 (2015) |
| Popis: | Objective: One of the most feared complications after pancreaticoduodenectomy (PD) remains postoperative pancreatic fistula (POPF). In the current study, we demonstrate a new technique for pancreaticogastrostomy (PG), using one continuous seromuscular circular suture without trans pancreas sutures for PG. Material and Methods: During the period December 2012 to December 2014, 32 consecutive patients underwent PD (either pylorus-preserving or classical Whipple’s) carried out using the above suture-less PG. Indication for PD was pancreatic duct carcinoma. Procedures were carried out by the same surgeon, same approach and anastomotic method in order to avoid technical changes. Results: Postoperative mortality was zero and morbidity was 21.8% (n=7). Pancreatic leakage (Grade A/B) occurred in 2 (6.2%) patients. These pancreatic leaks were managed nonoperative by maintaining the closed drains. The most common postoperative complication delayed gastric emptying (Grade B/C) in 3 (9.3%) patients. Conclusion: We conclude that the suture-less PG possesses several advantages over conventional PG and pancreaticojejunostomy (PJ). This technic seems to lessen the risk of a pancreatic leak, probably by diminishing the possibility of suture damage to the pancreas and by embedding the transected stump into the posterior gastric wall. This novel PG is a valid and valuable procedure, especially for soft, nonfibrotic pancreas. |
| Databáze: | OpenAIRE |
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